Purdue University Residences Parent Association
Questions marked with an asterisk (*) are mandatory.
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* First Name:
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* Last Name:
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* Email Address
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* Street:
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* City:
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* State:
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* Postal Code:
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Student's First Name:
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Student's Last Name:
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* Student's Year in School:
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* Student's Residence Hall:
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* I would like to make a gift to University Residences at the executive, representative, governor, or president levels. After submitting your senate-level registration, you will have the opportunity to Boiler Up! to the executive, governor, or president levels. You will receive two Purdue University Residences Parent Association T-shirts.